宫颈普通电刀锥切术与宫颈环行电切除术治疗CINⅢ的临床疗效研究

摘要

目的：评价宫颈普通电刀锥切术（EKC）和宫颈环行电切除术（LEEP）治疗宫颈上皮内瘤变Ⅲ级（CINⅢ）的临床疗效。方法回顾性分析该院妇科2007年2月至2012年3月收治的139例CINⅢ患者的临床资料，将行EKC治疗的67例患者作为EKC组，同期接受LEEP治疗的72例患者作为LEEP组。比较EKC和LEEP 2种手术方法治疗CINⅢ的临床疗效。结果（1）两组手术时间和术中出血量比较，差异无统计学意义（P>0.05）；（2）EKC组锥切标本高度大于LEEP组，LEEP组宫颈内口切缘阳性率高于EKC组，差异均有统计学意义（P<0.01）；（3）EKC组术后病灶残留率低于LEEP组，差异有统计学意义（P<0.01）；（4）EKC组术后病变复发率低于LEEP组，差异有统计学意义（P<0.05）；（5）EKC组术后高危人乳头瘤病毒（HPV）持续感染率低于LEEP组，差异有统计学意义（P<0.01）。结论 EKC和LEEP 2种治疗CINⅢ的方法均具有出血少、手术时间短的优点，但EKC治疗在标本大小、复发率及高危HPV持续感染方面要优于LEEP。%Objective To evaluate the clinical effects of general electrosurgical knife conization (EKC) and loop electro-surgical excision procedure(LEEP)in the treatment of cervical intraepithelial neoplasiaⅢ(CINⅢ). Methods The retrospective analysis of the clinical data was carried out in 139 cases of CIN III from February 2007 to March 2012 .67 cases undergoing EKC were taken as the EKC group and contemporaneous 72 cases receiving LEEP as the LEEP group. The clinical effects of EKC and LEEP in the treatment of CIN III were compared. Results (1)There was no statistically significant difference in the intraopera-tive blood loss volume and the operative time between these two groups (P>0.05);(2)the height of conization sample in the EKC group was greater than that in the LEEP group ,the positive rate of endocervical incisal margin in the LEEP group was higher than that in the EKC group,the difference was statistically significant(P<0.01);(3)the lesion residual rate in the EKC group was lower than that in the LEEP group,the difference was statistically significant (P<0.01);(4)The postoperative recurrent rate in the EKC group was lower than that in the LEEP group, the difference was statistically significant (P<0.05);(5)the high risk HPV persis-tent infection rate after operation in the EKC group was lower than that in the LEEP group ,the difference was statistically signifi-cant(P<0.01). Conclusion The EKC and LEEP methods all have the advantages of short operative time and less bleeding for treating CINⅢ,but the EKC treatment is superior to LEEP in the aspects of the specimens size ,recurrent rate and high risk HPV persistent infection.